Spiritual Care Needs of Terminal Ill Cancer Patients.

OBJECTIVE: Terminal ill cancer patients experience spiritual distress and need spiritual care. They are in need of palliative care in the long term to alleviate suffering. The aim of the study was to investigate spiritual needs of terminal ill cancer patients. METHODS: This study is a cross-sectional study. The participants were Thai terminal ill cancer patients from seven hospitals in northern, northeast, central, and southern regions of Thailand. Three-hundred-and-twenty-two participants were purposively selected. The instrument used in this study was a spiritual needs scale, consisting of 41 items with 4-point rating scale. Statistical analysis was F-test for one-way analysis of variance. RESULTS: The majority of terminal ill cancer patients aged fifty-one years old. Most of them were females with end stage cancer status that did not respond to treatment. The overall spiritual needs of terminal ill cancer patients were at the moderate level (M = 18.21, SD = 2.56). The highest mean was found in the 'prepare for death' dimension, followed by the 'have meaning, values, and life purposes' and the 'have opportunity to pursue most important things in life' dimensions respectively and had different spiritual needs among status (F(3,318) = 3.66, p < 0.05), number of family members (F(8,313) = 5.07,  p < 0.05), living with family (F(2,319) = 3.91, p < 0.05), and spiritual anchor (F(2,319) = 4.13, p < 0.05). CONCLUSION: The study results provide insight into spiritual needs of terminal ill cancer patients which assists in improving the provision of holistic care to let the patients be happy at end-of-life phase.

Proposing a conceptual framework of spiritual care competence for Chinese nurses.

Spiritual care competence of nurses is crucial to satisfy the spiritual needs of the clients, but the dearth of conceptual frameworks has hindered the clarification of the construct, especially for nurses in the People's Republic of China. This article developed a 3*3*3 matrix framework to clarify the components of spiritual care competence for Chinese nurses through the synthesis of existing empirical and theoretical work, which includes three aspects (awareness, understanding, and application) on three levels (intrapersonal, interpersonal, and transpersonal) of three contents of spirituality (namely, worldview, connectedness, and transcendence). The proposed framework can be used as a model to promote spiritual care competence of nurses in China. Adoption of the framework to guide studies would allow for the design of interventions for the attainment of this competence.

Embracing Our "Otherness".

Theories on the importance of holistic and spiritual healing within nonconventional models of care are vast, yet there is little written about the practical, clinical-level interventions required to deliver such practices in collaborative cross-cultural settings. This article describes the learning experiences and transformative journeys of non-Indigenous nurse practitioners working with a Cultural Lead from an Indigenous community in British Columbia, Canada. The goal of the Seven Sisters Healthy Heart Project was to improve heart health promotion in an Indigenous community through a model of knowledge translation. The article describes the development of a bridge between two cultures in an attempt to deliver culturally responsive programming. Our journeys are represented in a phenomenological approach regarding relationships, pedagogy, and expertise. We were able to find ways to balance two worlds-the medical health services model and Indigenous holistic models of healing. The key to building the bridge was our willingness to be vulnerable, to trust in each other's way of teaching and learning, and allowing diverse viewpoints and knowledge sources to be present. Our work has vast implications for health promotion in Indigenous communities, as it closes the gap between theory and practice by demonstrating how Indigenous models can be integrated into mainstream health promotion practices.

Reconsidering culturally competent approaches to American Indian healing and well-being.

There is an urgent need to eliminate mental health disparities experienced by American Indians and Alaska Natives (AI/ANs). Service providers and researchers often address these disparities by focusing on low rates of participation in Western mental health services. In part, this reflects limited understandings of the sociopolitical and historical context of AI/AN mental health problems. Furthermore, this emphasis fails to recognize the importance of emic understandings of locally resonant coping strategies, healing, and treatment. In this article, we describe (a) a study designed to address these gaps, (b) findings related to the importance of land and place, and (c) a community-university collaboration to translate these findings into meaningful change within one Diné community. Connections to the land were an important cultural strength on which to build efforts to promote mental health. Thus, effective treatment might involve more in-depth understanding of cultural processes through which healing occurs and well-being is maintained.

To heal and restore broken bodies: a retrospective, descriptive study of the role and impact of pastoral care in the treatment of patients with burn injury.

INTRODUCTION: Despite advances in resuscitation, resurfacing, and reconstruction, recovery in burn patients often depends upon emotional, psychosocial, and spiritual healing. We characterized the spiritual needs of burn patients to help identify resources necessary to optimize recovery. METHODS: We performed a retrospective review of all patients admitted to a regional, accredited burn center, in 2011. We accessed multiple clinical, financial, and administrative databases, collected demographic data, including religious affiliation, and recorded the number and type of pastoral care visits. Outcome measures included length of stay (LOS), physician and facility charges, and mortality. We compared patients who had a pastoral care visit with those who did not, as well as patients with a religious affiliation with those who had no or an unknown affiliation. RESULTS: During the study period, our burn center admitted 1338 patients, 314 of whom were visited by chaplains, for a total of 1077 encounters (3.43 visits per patient seen). Most frequent interventions were prayer, social support, and spiritual counseling. Compared to patients who had no visit, patients who saw a chaplain had a larger total body surface area burn, longer LOS, higher charges, and higher mortality (10.2% vs. 0.78%, P < 0.001). Patients who had a religious affiliation had slightly lower mortality than patients with unknown or no religious affiliation (0.87% vs. 3.19%), but this did not reach statistical significance. CONCLUSIONS: In burn patients, utilization of pastoral care appears to be linked to size of burn, financial charges, and length of stay, with religious affiliation serving as a possible marker for improved survival. Plastic surgeons and burn providers should consider and address the spiritual needs of burn patients, as a component of recovery.

Seeking and Utilizing a Curandero in the United States: A Literature Review.

PURPOSE: The purpose of this systematic review was to address two key questions: "Why do Hispanics seek a curandero?" And "How do Hispanics utilize the curandero?" METHODS: The literature was reviewed using two databases-PubMed and CINAHL-during the period January 2000 to September 2012-and reference lists for potentially relevant studies. The search terms used were Hispanics/Latinos, curandero, CAM use, and traditional healers/medicine. Terms were searched in the keywords, title, and abstract. FINDINGS: Of the 30 articles reviewed, 9 reflected the two key questions. Hispanics seek curanderos because they are affordable and are Spanish literate. Less common reasons include immigration status, culturally appropriate, spiritual healing, acculturation, and dissatisfaction with Western medicine. Hispanics utilize curanderos for a range of illnesses, including folk illnesses and treatments that may be unfamiliar to health care practitioners. IMPLICATIONS: Utilization of a curandero among the U.S. Hispanics was the focus of only four nursing articles on the practice of curanderos, but these did not address nursing implications. Knowledge of Hispanic folk illnesses and treatments is important in providing culturally appropriate holistic care. Furthermore, patient disclosure about the use of curanderos and folk remedies given may be critical to Western medical providers and the treatments they give.

Maori healers' views on wellbeing: the importance of mind, body, spirit, family and land.

From an indigenous and holistic perspective, the current dominant biomedical model of health and illness has a limited view of people and their wellbeing. The present study aimed to explore Maori spiritual healers' views on healing and healing practices, and the implications of these for conceptualisations of holism, health and wellbeing. Six indigenous Maori in Aotearoa/New Zealand took part in in-depth, semi-structured interviews with a Maori researcher from March to September 2007. Transcribed interviews were analysed using interpretative phenomenological analysis techniques. We found that Maori cultural perspectives influenced views of the mind, body, spirit and healers also identified two additional aspects as significant and fundamental to a person's health, namely whanau/whakapapa [family and genealogy] and whenua [land]. We propose a model called Te Whetu [The Star], with 5 interconnected aspects; namely, mind, body spirit, family, and land. Results are discussed in terms of the contribution of Maori knowledge to our understandings of health and wellbeing, and their implications for conceptualising holism, as well as health policy and care for Maori and other indigenous populations.

The role of spirituality healing with perceptions of the medical encounter among Latinos.

BACKGROUND: Little is known about the relationship between spirituality healing and perceptions about the medical encounter among Latinos. OBJECTIVES: To examine the association between spirituality healing and attitudes of self-reported perceptions about the medical encounter. DESIGN: A cross-sectional telephone survey. PARTICIPANTS: 3,728 Latinos aged >or=18 years residing in the United States from Wave 1 of the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey. MEASUREMENTS: Dependent variables were ever prayed for healing (yes/no), ever asked others to pray for healing (yes/no), considered important spiritual healing (very vs. somewhat or not important), and ever consulted a 'curandero' (folk healer in Latin America) (yes/no). The primary independent variables were feelings about the last time seeing a Doctor (confused by information given, or frustrated by lack of information) and perception of quality of medical care (excellent, good, fair or poor) within the past 12 months. RESULTS: Six percent of individuals reported that they had ever consulted a curandero, 60% prayed for healing, 49% asked others to pray for healing, and 69% considered spiritual healing as very important. In multivariable analyses, feeling confused was associated with increased odds of consulting a curandero (OR = 1.58; 95% CI, 1.02-2.45), praying for healing (OR = 1.30; 95% CI, 1.03-1.64), asking others to pray for healing (OR = 1.29; 95% CI, 1.03-1.62), and considering spiritual healing as very important (OR = 1.30; 95% CI, 1.01-1.66). Feeling frustrated by a lack of information was associated with asking others to pray for healing (OR = 1.29; 95% CI, 1.04-1.60). A better perception of quality of medical care was associated with lower odds of consulting a curandero (OR = 0.83; 95% CI, 0.70-0.98). CONCLUSION: Feelings about the medical encounter were associated with spirituality healing, praying for healing, and asking others to pray for healing. Feeling confused and perception of poor quality of medical care were associated with consulting a curandero.